Targeting AIDS prevention and treatment toward HIV-1-infected persons. The concept of early intervention

• Published in: JAMA : the journal of the American Medical Association Vol. 262; no. 18; p. 2572
• Main Authors: Francis, D P, Anderson, R E, Gorman, M E, Fenstersheib, M, Padian, N S, Kizer, K W, Conant, M A
• Format: Journal Article
• Language: English
• Published: United States 10.11.1989
• Subjects: Acquired Immunodeficiency Syndrome - diagnosis; Acquired Immunodeficiency Syndrome - economics; Acquired Immunodeficiency Syndrome - prevention & control; Acquired Immunodeficiency Syndrome - therapy; AIDS Serodiagnosis; Ambulatory Care - economics; Ambulatory Care - organization & administration; Behavior Therapy; Clinical Protocols; Confidentiality; Costs and Cost Analysis; Counseling; Follow-Up Studies; HIV-1; Humans; Longitudinal Studies
• ISSN: 0098-7484
• DOI: 10.1001/jama.1989.03430180114040

We propose establishing private and public outpatient facilities where persons with human immunodeficiency virus, type 1 (HIV-1), infection can receive state-of-the-art clinical and behavioral follow-up, treatment, and assistance. The possible advantages of enrolling HIV-1-positive persons into long-term follow-up are early treatment of clinical conditions and resulting gains in life quality and life expectancy, decreased transmission of HIV-1 to uninfected persons, more efficient use of scarce patient-care resources, and improved estimates of the total number of HIV-infected persons. The possible disadvantages of such a program are adverse psychological reactions to knowledge of HIV-1 infection, adverse societal actions against infected persons, and, finally, the economic cost of the program. These facilities, with the proper expertise and safeguards of confidentiality and trust, could prolong and improve the lives of infected persons while preventing infection of others.